Coronary Calcium Score High

[OldaYoda]

I’ve had results of a scan a month ago but no interpretation.

Calcium score is 2581 Agatston/Volume

Mildly calcified Aortic valve

High risk for obstructive CAD - precludes CTCA - alternative investigation advised.

Also mild cylindrical Bronchiectasis 😵‍💫

Question

Is the calcium score totally awful?

What might alternative investigation be?

How urgent do you think this is?

sorry - just enjoying a good old worry!

Les

[Chappychap]

Hello Les, interpreting Agatston calcium scores is far from straightforward, and I've heard different things from different cardiologists. It's important to emphasise that I'm not a doctor, but here are a few things that I've been told.

There's no dodging the fact a score of 2581 is very high, indeed some headline actuarial reports say any score over 1000 is equivalent to a one in three risk of heart attack within the next five years.

However, once you dig deeper it's not actually that simple. The most important thing is that "calcium" itself isn't really the problem as far as heart attacks are concerned. The risk comes from the soft plaque rupturing, not the stabilised plaque which has solidified over time into calcium. This calcium can cause angina, but it's only a risk factor for heart attacks rather than a primary cause. There are some people on this forum (myself included) with high levels of arterial blockage but who have never had a heart attack. We have a genetic tendency towards turning unstable soft plaque into stable, calcified deposits. Other people may be in the opposite camp, low levels of arterial blockage but may suffer heart attacks with no prior symptoms and possibly at a relatively young age.

So simply taking a single measurement of calcification is far from the whole story. Indeed I've been told that the more important measurement for me was to take a second measurement after a few years and see if the score has increased. Some cardiologists say that a relatively high but stable score is actually less risky than a lower but fast growing score. However, I should be clear that I heard this in the context of scores in the low hundreds rather than in thousands.

One final point. Medication and serious life style changes can significantly reduce your risk independent of your calcium score. So for example if you can get your lipid scores, your HbA1c scores, your blood pressure, and your BMI scores all into the safe zone, plus eat healthily, drink moderately, quit nicotine, and exercise to NHS recommended guidelines; then your risk of a heart attack or stroke can be massively reduced (particularly if you haven't had a previous heart attack) even with a relatively high calcium score.

I hope this helped.

Good luck!

[OldaYoda in reply to Chappychap]

Thanks Chappy,

I’ve had a message from GP saying not to worry too much . Seeing them next week.

Apparently the consultant wants to do more tests. Just hoping that the superhigh score is not quite right😀

Will update when I get more news

[OldaYoda in reply to OldaYoda]

Update - GP message / I’m on right meds, don’t worry too much, see you Wednesday .